中国血液净化

›› 2011, Vol. 10 ›› Issue (8): 426-428.doi: 10.3969/j.issn.1671-4091.2011.08.00

• 临床研究 • 上一篇    下一篇

替米沙坦改善维持性血液透析患者微炎症和氧化应激状态

姚 丽 魏丹丹 葛丹梅 魏 敏 耿 野 冯茂玲 王力宁   

  1. 中国医科大学附属第一医院肾内科
  • 收稿日期:2011-01-28 修回日期:1900-01-01 出版日期:2011-08-12 发布日期:2011-08-12
  • 通讯作者: 王力宁

Telmisartan improves micro-inflammation and oxidative stress in patients with maintenance hemodialysis

YAO Li, WEI Dan-dan, GE Dan-mei, WEI Min, GENG Ye, FENG Mao-ling, WANG Li-ning   

  1. Department of Nephrology, the First Hospital of China Medical University, Shenyang 110001, China
  • Received:2011-01-28 Revised:1900-01-01 Online:2011-08-12 Published:2011-08-12

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摘要：

目的 探讨替米沙坦对维持性血液透析(maintenance hemodialysis,MHD)患者微炎症及氧化应激状态的影响。 方法 60例行MHD治疗的慢性肾衰竭患者,随机分为替米沙坦治疗组(T组，30例)和非替米沙坦治疗组(NT组，30例),并设健康对照组(30例)。检测治疗前及治疗24周时血清高敏C反应蛋白(high sensitivity C-reactive protein,hs-CRP)、白细胞介素6(interleukin-6,IL-6)、肿瘤坏死因子(tumor necrosis factor-,TNF-)、脂质过氧化物丙二醛(malondialdehyde,MDA)、前白蛋白(prealbumin,PA)和白蛋白(albumin,Alb)的水平。 结果 与健康对照组比较，MHD患者hs-CRP升高，分别为(8.1±2.6)mg/L和(1.5±0.7)mg/L，IL-6升高，分别为(349.0±52.4)ng/L和(53.6±15.0)ng/L，TNF-嵘撸直鹞(8.1±2.2)ng/L和(2.1±0.8)ng/L，MDA升高，分别为(7.3±3.2)祄ol/L和(3.5±0.9)祄ol/L，差异均有统计学意义(P＜0.05)；PA降低，分别为(20.6±7.3)mg/dl和(28.4±4.0)mg/dl，差异有统计学意义(t=-6.542 ,P＜0.05)。治疗前T组与NT组hs-CRP、IL-6、TNF-帷DA、PA及Alb水平差异无统计学意义(P＞0.05)。替米沙坦治疗24周时，与NT组相比，T组血清hs-CRP降低，分别为(5.6±1.8)mg/L和(8.2±2.8)mg/L，IL-6降低，分别为(218.6±45.9)ng/L和(363.0±67.4)ng/L，TNF-峤档停直鹞(5.3±1.7)ng/L和(8.7±2.3)ng/L，MDA降低，分别为(4.6±2.2) 祄ol/L和(7.5±3.7)祄ol/L)，差异均有统计学意义(P＜0.05)；PA升高，分别为(25.3±6.7)mg/dl和(20.0±7.7)mg/dl，差异有统计学意义(t=-3.362 ,P＜0.05)。 结论 替米沙坦可改善MHD患者微炎症、氧化应激及营养不良状态。

关键词: 维持性血液透析, 微炎症, 氧化应激, 替米沙坦

Abstract:

Objective To evaluate the effect of telmisartan on micro-inflammation and oxidative stress in maintenance hemodialysis (MHD) patients. Methods Sixty stable MHD patients and 30 healthy volunteers (control) were involved in this study. The MHD patients were randomly divided into telmisartan treatment group (group T; n=30) or non-telmisartan treatment group (group NT; n=30). Patients in group T took telmisartan at a dose of 80mg per day for 24 weeks. Plasma high-sensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor (TNF-a), lipid peroxide malondialdehyde (MDA), serum prealbumin (PA), and serum albumin (Alb) were measured before telmisartan treatment and after the treatment for 24 weeks. Results When comparisons were performed between MHD patients and healthy controls, plasma levels of hs-CRP (8.1±2.6 vs. 1.5±0.7mg/L), IL-6 (349.0±52.4 vs. 53.6±15.0ng/L), TNF-a (8.1±2.12 vs. 2.1±0.8ng/L) and MDA (7.3±3.2 vs. 3.5±0.9μmol/L) were significantly higher in MHD patients, and serum PA (20.6±7.3 vs. 28.4±4.0mg/dL) was significantly lower in MHD patients than in healthy controls (P＜0.05, respectively). When comparisons were conducted between group T and group NT, plasma levels of hs-CRP (5.6±1.8 vs. 8.2±2.8mg/L), IL-6 (218.6±45.9 vs. 363.0±67.4ng/L), TNF-a (5.3±1.7 vs. 8.7±2.3ng/L) and MDA (4.6±2.3 vs. 7.5±3.7μmol/L) were significantly lower, and serum PA (25.3±6.7 vs. 20.0±7.7mg/dL) was significantly higher in group T after telmisartan treatment for 24 weeks than in group NT (P＜0.05, respectively). Conclusion Telmisartan improves micro-inflammation, oxidative stress and malnutrition in MHD patients.

Key words: Micro-inflammation, Oxidative stress, Telmisartan

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